BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1288
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          Date of Hearing:   May 15, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

               AB 1288 (V. Manuel Pérez) - As Amended:  April 11, 2013

          Policy Committee:                              Business,  
          Professions and Consumer Protection           Vote: 12-1

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill requires the Medical Board of California (MBC) to  
          develop a priority review process for applicants for a  
          physician's and surgeon's certificate who demonstrate their  
          intent to practice in a medically underserved area (MUA) or  
          serve a medically underserved population (MUP), as specified.

           FISCAL EFFECT  

          Costs to MBC should be minor and absorbable to develop the  
          required review process.  This bill does not require any  
          outreach or other activities by MBC to put an applicant on the  
          priority list.  Rather, this bill specifies acceptable  
          documentation for an applicant to submit to demonstrate intent,  
          including but not limited to, a letter from an employer  
          indicating the applicant has accepted employment and stating the  
          start date.   

           COMMENTS  

           1)Rationale  .  This bill aims to increase the number of newly  
            certified physicians and surgeons practicing in MUAs or  
            serving a MUP by requiring MBC to develop a priority review  
            process for applicants for a physician's and surgeon's  
            certificate for licensure that demonstrate an intent to do so.  
            This bill is sponsored by the California Medical Association.  
            According to the author, there is not currently a backlog of  
            applications but in the past backlogs did occur due to  budget  
            actions and an influx of applications.   

           2)Licensing application process  . MBC's initial review process  








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            for license applications must be completed within 60 business  
            days. According to MBC's website, the entire process can be  
            lengthy and individuals are encouraged to start the  
            application process at least six to nine months before they  
            intend to practice. Once a file is reviewed, the applicant is  
            notified in writing of the application status and given an  
            itemized list of documents needed to complete the file. The  
            missing documents requested by MBC are reviewed in order of  
            receipt. Only about 10% of applications are found to be  
            complete at the initial review. The additional documents  
            required for a physician and surgeon certificate often must be  
            sent directly from hospitals or other entities, which may help  
            explain the high level of incompletion and the long delays. If  
            a file is complete upon initial review, the license will be  
            issued within seven to ten days.

          3)Currently, MBC finds that it is completing an initial review  
            of applications within 45 calendar days, well under the  
            mandated 60 business days. MBC does not request any  
            information regarding where an applicant plans to work once  
            licensed. During fiscal year 2011-12, MBC received 6,623  
            applications and granted 5,351 licenses. Although MBC is not  
            currently experiencing a licensing backlog, this bill will  
            still require MBC to establish a priority review process in  
            order to streamline the application process for those  
            physician and surgeon applicants who can demonstrate their  
            commitment in writing to working in MUAs or serving MUPs.

           4)Medically underserved areas and populations  . MUAs are defined  
            as healthcare shortage areas as specified in federal  
            regulations or an area of the state where unmet needs for  
            physicians exist as determined by the Office of Statewide  
            Health Planning and Development (OSHPD). The Commission  
            reviews and designates priority geographic areas in California  
            to address the unequal distribution of healthcare services  
            where unmet medical needs persist. Among the areas that are  
            designated as MUAs are Modoc County and portions of Trinity,  
            Inyo, Riverside, Shasta, Del Note, Tulare and Kings Counties.  
            MUPs are areas where persons are served by the Medi-Cal or  
            Healthy Families programs, or where there is an uninsured  
            population. Examples of areas that are designated by OSHPD as  
            MUPs are Mendocino County and portions of Lassen, Tulare,  
            Plumas and Riverside counties.
           
          Analysis Prepared by  :    Debra Roth / APPR. / (916) 319-2081 








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